DESCRIPTION: (after the application) To date, no studies have been published that record the health utilities of patients co-infected with HIV/HCV. Understanding the process by which patients with HIV/HCV assign health utilities, weighing the benefits of therapy against the potential adverse effects is paramount. It would help gain an understanding of what is important in patients' lives and thereby facilitate patient-centered approaches to initiating and continuing antiviral therapy, and potentially even inform intervention trials to improve HRQOL, or improve adherence once therapy is begun. Furthermore, it may add to the understanding of how people incorporate multiple illnesses into their health preferences. Finally, it would help policy makers take into account patient preferences in formulating guidelines and allocating resources. The applicant thus proposes a one -year study with two major aims: 1) To assess health utilities of patients co-infected with HIV/HCV and to compare them with those of patients singly infected with HIV or with HCV; and 2) To characterize and assess the relationship of clinical and non-health-related factors to health utilities. The applicant plans to interview 120 patients at the University of Cincinnati Medical Center with various stages of HCV-infection (60 patients) and HIV/HCV co-infection (60 patients) to ascertain their health utilities for their current state of health. The questionnaire battery will include: 1) computer-assisted utility assessment (rating scale, time tradeoff, and standard gamble); 2) the HAT-QoL health status instrument (only for those HIV-infected); 3) the Hepatitis Quality of Life Questionnaire; 4) the CESD-10 depression scale; 5) the FACIT-SpEx scale, a measure of spirituality and religiosity; 6) the Brief Interpersonal Support Evaluation List, a 12-item measure of social support; 7) Rosenberg's six-item global self-esteem measure; 8) the Life Orientation Test, a 12-item measure of optimism; and 9) the Jackson Personality Index, a six-item measure of risk attitudes. To address Specific Aim 1, the applicant will describe the health utilities of those co-infected with HIV/HCV (rating scale, time trade-off, and standard gamble) and compare these values with those of patients singly infected with HCV and with HIV. For Specific Aim 2, study instruments will allow the applicant to characterize and assess the relationship of clinical and non-health-related factors to health utilities. Associations will be sought by using both univariate statistical techniques and multivariable regression analyses.